Astonishingly, these types of questions on the internet regarding the difference between medical illness and psychiatric presentations are being answered by people who are not medical doctors. Getting medical advice from someone who is not a medical doctor can be life-threatening. Fortunately, at AnxietyBoss.com, all the questions and content are written and edited by Dr. Carlo Carandang MD, a psychiatrist, medical doctor, and Fellow of the American Psychiatric Association.
Okay, let’s get back to answering the question. When you are having a panic attack, the question “Is this a heart attack?” invariably comes up. What makes it difficult to tell the difference is that they share similar symptoms: chest pains, shortness of breath, sweating, dizziness, and fatigue. Just based on symptoms alone, it is difficult to distinguish the chest pains from panic disorder from the chest pains of a heart attack. The only way to determine the cause of the chest pain is to go to the emergency department and get an electrocardiogram (ECG) and cardiac enzymes to rule out a myocardial infarction. In addition, panic disorder and coronary artery disease can co-exist, so if one is diagnosed, then the other needs to be investigated.
In people presenting with chest pain in the emergency department, the following correlates with the presence of panic disorder (Katerndahl, 2004):
- Younger age
- Atypical chest pain (non-cardiac pain, pain in the right arm or hand)
- Presence of depression, anxiety, or phobia
As a reminder, it is important to seek medical attention for chest pains, as it could be a heart attack. The job of determining the cause of the chest pain is for the doctor only, given the mortality from myocardial infarction. When organic causes of the chest pain are ruled out, then panic disorder can be considered in those who are younger, present with non-cardiac type of pain, have pain in the right arm, and have depression, anxiety, or phobia.